Faculty of Medicine
Department of General Surgery
Intended Learning Outcomes (ILOs)
Curriculum & Programme Evaluation Committee
Internal Quality Committee
General Surgery (Junior)
Course Number Credit Hours Sequence
6202411 10 Fourth Year
Course Coordinator Dr.Marwan Abufarah
E.mail marwan_abufara@yahoo.com
Course Description:
This is an eight-week rotation course offered to fourth-year students. The description of General
Surgery in its special requirements for student education as a "discipline having a central core of
knowledge embracing anatomy, metabolism, immunology, nutrition, pathology, wound healing,
shock and resuscitation, intensive care and neoplasia. General Surgery includes knowledge and
skill relating to the diagnosis, preoperative, operative, and postoperative management in the
following areas of primary responsibility such as alimentary tract; abdomen and its contents;
breast, skin and soft tissue, head and neck, vascular system, endocrine system, surgical oncology,
comprehensive management of trauma, and care of critically ill patients.
Course General Objectives
The course aims to prepare students to identify disease processes and clinical situations in
which surgical intervention is appropriate. Students will be able to demonstrate competencies
in the basic knowledge, skills, and attitudes of an effective clinician in evaluating and caring
for surgical problems. Students in the fourth year will focus on the importance of history and
physical examinations. Also to enable the development and application of appropriate
professional attitudes, ethical principles, and communication skills.
Intended Learning Outcomes of Course (ILOs)
A. Recall of Knowledge and Understanding:
By the end of the course, students will be able to:
● Recognize the basics of surgical ethics.
● Describe the anatomy, histology, and physiology of surgically important structures,
organs, and regions.
● Describe the principles of molecular biology and wound healing.
● Describe the microbiology and parasitology of surgically important pathogens.
● Demonstrate knowledge regarding history and physical examination.
● Demonstrate knowledge and understanding of common surgical problems.
● Describe the epidemiology, etiology, pathophysiology, pathology, complications, and
prognosis of the various common and important surgical diseases and disorders.
● Define principles of clinical audit.
B- Intellectual Skills
By the end of the course, students will be able to:
● Assemble the necessary data and information necessary for the evaluation of patients for
routine surgery.
● Identify common surgical problems in the inpatient and ambulatory setting.
● Recognize patients with life/organ-threatening surgical conditions.
● Determine the different strategies for risk management of disease and injury.
● Identify surgically important structures and organs.
● Integrate the results from history, clinical examination, and investigational data into
meaningful diagnostic formulation using basic anatomical, physiological, and
pathological facts with clinical data.
● Identify problems, prioritize them, and generate a list of differential diagnoses for each
problem.
C. Professional and Practical Skills
By the end of the course, students will be able to:
● Take a history and perform a physical exam on patients who are prospects for surgery.
● Evaluate and assess patients with surgical diseases.
● Demonstrate knowledge of measuring and recording vital signs.
● Apply specific protocols in the operating room (scrubbing, gowning, gloving, prepping,
and draping).
● Demonstrate knowledge of and proper usage of commonly used surgical instruments.
● Perform venipuncture and collect blood samples.
● Insert a cannula into peripheral veins.
● Perform suturing of superficial wounds.
● Administer basic oxygen therapy.
● Perform and interpret basic bedside laboratory tests.
● Adopt suitable measures for safety and infection control.
D. General and Transferable Skills
By the end of the course, students will be able to:
● Document data, assessment, and plans in the patient’s record and progress notes.
● Communicate effectively with other healthcare professionals, attending physicians,
residents, physician assistants, nurses, and other students.
● Communicate effectively with patients and their relatives and present surgical patients
during teaching sessions.
● Adopt the principles of lifelong learning needs of the medical profession.
● Use computers efficiently in reaching biomedical information to remain current with
advances in knowledge and practice.
● Communicate ideas and arguments effectively.
● Work effectively within a multidisciplinary team.
● Manage time and resources effectively and set priorities.
Course Summary:
This eight-week course in a hospital-based service is intended to be a structured clinical
experience under direct supervision. This rotation is a time to build a foundation in clinical
problem-solving and decision-making as well as a time to build clinical experience. Upon
completion of the rotation, the student should be able to master and elicit surgical history,
perform physical examination, assess the findings, and develop a differential diagnosis for
common surgical principles and practices.
Methods of Teaching:
● Lectures and seminars.
● Round table discussion.
● Teaching rounds.
● Outpatient clinic attendance.
● Case presentation.
● Morning reports for the students.
● Bedside teaching.
● Attending inpatient floor and learning clinical assessment and management methods
supervised by consultants and fellows.
● Attend operation theatres to observe surgical procedures & operations.
Theoretical Sessions (TS)
1. Preoperative - Common Postoperative Complications
- Evaluation of Surgical Risk
Evaluation and - Postoperative Pain
Perioperative Care - Instructions to Patient
- Ventilatory Support/Management
2. Neuro-hormonal - Injury-Associated Systemic Inflammatory Response
response to injury - The Detection of Cellular Injury
- Central Nervous System Regulation of Inflammation in
Response to Injury
- Mediators of Inflammation
- Cellular Response to Injury
- Cell-mediated inflammatory Response
- Endothelium-Mediated Injury
3. Intestinal Failure & - Effect of Surgery, Illness and Injury on Nutritional
nutritional support Requirements
- Nutritional Assessment
- Nutritional Pharmacology and Immunonutrition
- Nutritional Requirements
- Indications for Nutritional Support
- Enteral Nutrition
4. Fluid Electrolyte - Anatomy and Physiology of Body Fluid and Electrolytes
Exchange
and Acid-Base - Assessing Volume Status
Balance - Volume Deficit and Excess
- Sodium, Potassium, Calcium, Magnesium and Phosphorus
Balance
- Metabolic and Respiratory Acidosis
- Metabolic and Respiratory Alkalosis
5. Acute Hemorrhage - Evaluation of Ongoing Bleeding and Laboratory
Assessment of Coagulation
Hemostasis and - Inherited and Acquired Disorders of Coagulation
Blood Transfusion - Normal Mechanisms of Hemostasis and Coagulation
- Transfusion – Indications, Risks, Type and Crossmatch,
and Component Therapy
6. Surgical Critical - Abdominal Compartment Syndrome
- Acute Respiratory Distress Syndrome (ARDS)
Care - Anaphylaxis
- Brain Death
- Obstructive Shock
- Cardiac Arrest
- Cardiac Arrhythmias – Common
- Cardiac Failure and Cardiogenic Shock
- Derangements of Electrolytes and Acid-Base Balance
- Endocrine Dysfunction
- Hepatic Failure and Hepatorenal Syndrome
- Hypovolemic Shock
- Hypoxemic Syndromes (Pulmonary Embolism,
Pneumonia)
- Neurogenic Shock
- Neurologic Dysfunction
- Pain, Agitation, and Delirium
- Renal Failure
- Respiratory Failure
- Sepsis and Septic Shock
7. Surgical infections - Classification and Pathophysiology
- Common Surgical Pathogens
- Antimicrobial Prophylaxis
8. Major trauma and - Cardiac Injury
- Chest Wall, Pleural and Diaphragm Injuries
the - Colon and Rectal Injury
multiple-injured - Duodenal and Pancreatic Injury
patient - Esophageal Injury
- Frostbite and Hypothermia
- Gastric and Small Intestinal Injury
- Geriatric Trauma
- Hepatic Injury
- Initial Assessment and Management of Trauma
- Lower Urinary Tract Injuries
- Pediatric Trauma
- Pelvic Fractures and Retroperitoneal Hematoma
- Splenic Injury
- Tracheobronchial and Lung Injury
- Trauma in Pregnancy
- Traumatic Brain Injury
- Upper Aerodigestive Tract Injury
- Upper Urinary Tract Injuries
- Vascular Injury – Abdomen, Extremities, Neck and Thorax
- Bite and Envenomation Injuries
- Brachial Plexus Injury
- Extremity Injuries
- Spinal Cord Injury
9. General Abdomen - Abdominal Pain – Acute and Chronic
- Rectus Sheath Hematoma
10. Burns - Initial Evaluation, Classification of Burns and Burn Depth
- Indication for Referral to Burn Center
- Fluid Resuscitation
- Burn care
- Smoke Inhalation Injury and Carbon Monoxide Poisoning
- Electrical injury
- Chemical injury
- Nutrition of Burn Patients
- Burn Scar Cancer
11. Wound healing and - Wound Closure and Postoperative Care
- Steps of Wound Healing
management - Surgical Wound Classification
- Types of Wound Healing
- Factors Affecting Wound Healing
- Excess Healing
12. Surgical skin - Anatomy and Histology
- Cellulitis
disorders and - Hidradenitis
subcutaneous tissue - Melanoma and Nevi
- Necrotizing Soft Tissue Infections
- Nonmelanoma Skin Cancers
- Paronychia and Felon
- Pilonidal Cyst/Sinus
- Pressure Ulcer
- Soft Tissue Masses – Evaluation
- Soft Tissue Sarcomas
- Lymphedema/Lymphangitis
13. Breast - Embryology, fundamental Anatomy and physiology of the
Breast, boundaries for mastectomy and axillary dissection
- Evaluation of Palpable Breast Mass
- Atypical Hyperplasia, Flat Epithelial Atypia, and Lobular
Carcinoma in Situ
- Benign Disease – Fat Necrosis, Fibrocystic Breast
Changes, and Radial Scar
- Benign Inflammatory Disease – Mastitis, Abscess, and
Mondor Disease
- Breast Cancer – Hereditary, Inflammatory, Invasive
Carcinoma (Ductal, Lobular, All Variants), Paget Disease
of the Nipple
- Breast Disease During Pregnancy and Lactation
- Breast Mass
- Ductal Carcinoma in Situ
- Fibroadenoma and Phyllodes Tumors
- Male Breast Disease – Gynecomastia and Breast Cancer
- Nipple Discharge and Intraductal Papilloma
- Postmastectomy Reconstruction Options
- Radiographic Abnormalities
14. Salivary glands - Anatomy and Physiology
- Benign/Systemic disease
- Tumors-Benign and Malignant
15. The neck - Surgical Anatomy of the neck
- Congenital Disease of the neck
- Infectious/inflammatory lesions
- Malignancy
- Neck Mass – Evaluation
- Upper Airway Obstruction
16. Arterial Disease - Anatomy and Histology of Arterial System
- Acute Thrombosis and Ischemia
- Cerebrovascular Disease
- Compartment Syndromes
- Diabetic Foot Infections
- Peripheral Arterial Emboli
- Peripheral Vascular Occlusive Disease
- Acute Aortic Dissection
- Arterial Aneurysms – Aortic
- Arterial Aneurysms – Peripheral
- Arterial Aneurysms – Visceral
- Nonatherosclerotic Occlusive Diseases
- Renal Artery Disease
- Thoracic Outlet Syndrome
- Vascular Graft Infections
17. Venous disorders - Venous Anatomy
- Evaluation of the Swollen Leg
- Thrombophlebitis
- Varicose Veins
- Venous Stasis/Chronic Venous Insufficiency
- Venous Thromboembolism
18. Lymphatic disorders - Main function of the lymphatic system
- Various causes of limb swelling
- Etiology, clinical features, investigations, and treatment of
lymphoedema
19. Esophagus - Surgical Anatomy, Physiology and Histology of the
Esophagus.
- Esophageal Motility Disorders
- Esophageal Neoplasms – Benign and Malignant
- Esophageal Perforation or rupture
- Gastroesophageal Reflux/Barrett Esophagus
- Hiatal Hernias
- Esophageal Caustic Ingestion and Foreign Bodies
20. Stomach - Review of the Anatomy, Physiology and Histology of the
Stomach.
- Functional Disorders of the Stomach
- Gastric Adenocarcinoma
- Gastric Outlet Obstruction
- Gastric Foreign Bodies
- Gastrointestinal Bleeding – Upper
- GISTs and Miscellaneous Neoplasms
- Morbid Obesity and Bariatric Surgery
- Peptic Ulcer Disease
- Stress Gastritis
- Postgastrectomy Complications
21. Small Bowel - Gastrointestinal (GI) Embryology and GI Hormones
- Gross Anatomy and Histology of the Small Intestine
- Enterocutaneous Fistula
- Meckel Diverticulum
- Mesenteric Ischemia – Acute (Arterial, Venous, and
Nonocclusive)
- Paralytic Ileus
- Radiation Enteritis
- Small Intestinal Neoplasms
- Small Intestinal Obstruction
- Enteric Infections/Blind Loop Syndrome
- Short Bowel Syndrome
- Crohn’s Disease
22. Large Bowel - Embryology, Anatomy and Physiology of large intestine.
- Colitis – Ischemic, Pseudomembranous, and
Radiation-induced
- Inflammatory Bowel Disease: Ulcerative colitis
- Colon Cancer
- Colonic Polyps
- Colonic Volvulus and Obstruction
- Diverticular Disease
- Gastrointestinal Bleeding – Lower
- Functional Disorders of the Intestine
- Polyposis Syndromes
- Large Bowel Obstruction and Pseudo-obstruction
23. Appendix - Embryology and Anatomy of Appendix
- Appendicitis
- Appendiceal Neoplasms
- Appendiceal Abscess
24. Anorectal Disease - Review of Embryology and Anatomy of Anorectal canal
- Anal Cancer
- Anal Dysplasia and STDs
- Anal Fissure
- Anorectal Abscess and Fistulae
- Hemorrhoids
- Rectal Cancer
- Fecal Incontinence
- Rectal Prolapse
25. The liver - Surgical Hepatic Anatomy
- Cirrhosis/Portal Hypertension (Ascites)
- Hepatic Abscess and cysts
- Hepatic Neoplasms – Metastatic
- Primary Hepatic Neoplasms – Benign and Malignant
26. Biliary system - Review of the anatomy, and physiology of the biliary
system,
- Benign Biliary Obstruction
- Bile Duct Injury – Iatrogenic
- Biliary Neoplasms
- Cholecystitis
- Choledochal Cyst
- Functional Biliary Disorders
27. Pancreas - Embryology, anatomy, Histology and physiology of
pancreas
- Pancreatitis – Acute/Pancreatic Necrosis/Abscess, Chronic
(Including Hereditary Pancreatitis)/Pancreatic Insufficiency
- Cystic Lesions of the Pancreas
- Pancreatic Neoplasms – Endocrine, Exocrine, and
Intraductal Papillary Mucinous Neoplasms
- Pancreas Divisum
28. Spleen - Spleen histology and anatomaical boundaries
- Hematologic Diseases of the Spleen
- Splenectomy :indications ,types and complication
- Splenic Abscess, Cysts and Neoplasms
29. Hernia and - Classification of Hernias
- General Groin Anatomy
Abdominal wall - Inguinal and Femoral Hernias
problems - Miscellaneous Hernias
- Umbilical and Epigastric Hernias
- Ventral Hernia
30. Peritoneum, - Causes and compilations of localized and generalized
omentum, and peritonitis
- Clinical feature of peritonitis and intraperitoneal abscess
mesentery - The causes and pathophysiology and complications of
ascites
- Pathophysiology and complications of adhesion formation
- Desmoids/Fibromatoses
- Peritoneal Neoplasms
31. Endocrine surgery - Endocrine glands Anatomy and Hormones Physiology
- Multiple Endocrine Neoplasias
- Adrenal Mass – Incidental
- Hyperaldosteronism – Primary
- Hypercortisolism – Cushing Syndrome/Disease
- Adrenal Cancer
- Hyperparathyroidism
- Parathyroid Cancer
- Hyperthyroidism
- Hypothyroidism – Postoperative
- Thyroid Cancer
- Thyroid Nodule
- Thyroiditis
- Pheochromocytoma
32. Urology - Acute Urinary Retention
- Hydrocele
- Scrotal Pain and Masse
- Genitourinary Neoplasms
33. Minor procedures
Evaluation:
Written exam (final exam): 50%
OSCE modality exam: 40%
Evaluation (from Tutor): 10%
TOTAL: 100%
Recommended Text Books:
● Textbooks of Surgery:
1- Bailey and Love's – Short Practice of Surgery
2- Schwart's – Principles of Surgery
3- Essential Surgical Practice – A. Cuschieri
● For Clinical:
1- Hamilton Bailey's (demonstrations of physical signs in clinical surgery)
2- Browse’s Introduction to symptoms and signs of Surgical Diseases.
3- Essential Surgery: problems, diagnosis, and management by H. Burkitt.
